Even after 14 years, law to regulate charges in private hospitals not in force

New Delhi: With the governments doing barely anything on regulating the charges of medical services in private hospitals, mandated by a law passed 14 years ago, at least two groups of doctors have now decided to intensify their campaign to nudge the Centre and state governments to implement the patient-friendly law.

The Clinical Establishment Act, passed by the Parliament in 2010 and subsequent rules framed in 2012 not only set the standards for private hospitals and nursing homes, but also fixed the rates and charges for services offered at medical establishments.

While 12 states have adopted the law, none implemented it properly. A number of associations representing hospitals have now approached the Supreme Court challenging the Centre’s authority to determine the rates charged in private hospitals.

“In the absence of effective regulation, millions of people are exposed to exploitation by private hospitals. Neither the central govt nor the state governments are taking measures to effectively implement central or state level legislation,” said Abhay Shukla, a physician and co-convenor of Jan Swasthya Abhiyan.

All hospitals and clinical establishments are required to meet minimum standards before they are given permanent registration under the Act. These standards were to be notified by 2014, but did not come out even after 10 years.

Draft standards were issued in 2019, but the Union government hasn’t made them permanent in the last five years. Among other things, the standards make it a must for hospitals to publicly display the charges for various procedures.

As a result, the 12 states that adopted the law give only temporary registration to private hospitals and nursing homes. They include Uttar Pradesh, Rajasthan, Assam, Jharkhand, Bihar, Haryana, Telangana, Uttarakhand, Himachal Pradesh and three other NE states.

Six other states including Karnataka have their own regulatory laws, but there are variations in their provisions.

“We need to shake the government out of induced paralysis. We will increase public awareness and also reach out to Parliament members telling them about such a huge inexcusable delay in implementing the law,” Shukla said.

Earlier this year, five associations of doctors and private hospitals including the Indian Medical Association and the Association of Healthcare Providers of India approached the Supreme Court arguing it would be not possible to standardise the rates and regulate the charges in private healthcare. “We will submit our intervention in the SC,” Shukla said.

The Forum for Equity in Health, another group of doctors, has come out with a testimonial signed by more than 100 doctors, who say they regularly observe in their clinical practice how a considerable number of patients grapple with the overwhelming financial burden imposed by private healthcare expenses.

“In the absence of regulations, caesarean deliveries may cost anywhere between Rs 30,000–150,000, depending on hospitals. Such exploitative pricing should not be allowed,” Shukla said.

“The exorbitant costs and often arbitrary charging associated with private healthcare in India have become a source of economic distress for many, with at least 60 per cent of healthcare expenditures borne directly by patients themselves,” said the physicians who signed the testimonial.